Trump action on health care could cost Planned Parenthood

WASHINGTON (AP) — One of President-elect Donald Trump's first, and defining, acts next year could come on Republican legislation to cut off taxpayer money from Planned Parenthood.

Trump sent mixed signals during the campaign about the 100-year-old organization, which provides birth control, abortions and various women's health services. He said "millions of women are helped by Planned Parenthood," but he also endorsed efforts to defund it.

Trump once described himself as "very pro-choice." Now he's in the anti-abortion camp.

Still, the Republican has been steadfast in calling for repeal of President Barack Obama's health care law, and the GOP-led Congress is eager to comply. One of the first pieces of legislation will be a repeal measure that's paired with cutting off money for Planned Parenthood. While the GOP may delay the impact of scuttling the law for almost four years, denying Planned Parenthood roughly $400 million in Medicaid funds would take effect immediately.

"We've already shown what we believe with respect to funding of Planned Parenthood," House Speaker Paul Ryan, R-Wis., told reporters last month. "Our position has not changed."

Legislation to both repeal the law and cut Planned Parenthood funds for services to low-income women moved through Congress along party lines last year. Obama vetoed it; Trump's win removes any obstacle.

Cutting off Planned Parenthood from taxpayer money is a long-sought dream of social conservatives, but it's a loser in the minds of some GOP strategists. Planned Parenthood is loathed by anti-abortion activists who are the backbone of the GOP coalition. Polls, however, show that the group is favorably viewed by a sizable majority of Americans — 59 percent in a Gallup survey last year, including more than one-third of Republicans.

"Defunding Planned Parenthood as one of their first acts in the new year would be devastating for millions of families and a huge mistake by Republicans," said incoming Senate Minority Leader Chuck Schumer, D-N.Y.

Democrats pledge to defend the group, and they point to the issue of birth control and women's health as helping them win Senate races in New Hampshire and Nevada this year. They argue that Trump would be leading off with a political loser. But if he were to have second thoughts and if the Planned Parenthood provision were to be dropped from the health law repeal, then social conservatives probably would erupt.

"They may well be able to succeed, but the women of America are going to know what that means," said Rep. Diana DeGette, D-Colo., citing reduced access to services Planned Parenthood clinics provide. "And we're going to call Republicans on the carpet for that."

At least one Republican senator, Susan Collins of Maine, may oppose the effort. Collins has defended Planned Parenthood, saying it "provides important family planning, cancer screening and basic preventive health care services to millions of women across the country." She voted against the health overhaul repeal last year as a result.

Continued opposition from Collins, which appears likely, would put the repeal measure on a knife's edge in the Senate, where Republicans will have a 52-48 majority next year. Senate GOP leaders could afford to lose just one other Republican.

Anti-abortion conservatives have long tried to cut Planned Parenthood funds, arguing that reimbursements for nonabortion services such as gynecological exams help subsidize abortions. Though Planned Parenthood says it performed 324,000 abortions in 2014, the most recent year tallied, the vast majority of women seek out contraception, testing and treatment of sexually transmitted diseases, and other services including cancer screenings.

The drive against Planned Parenthood picked up steam in 2015 after an anti-abortion group called the Center for Medical Progress released secretly-recorded videos that it claimed showed Planned Parenthood officials profiting from sales of fetal tissue for medical research. The measure, however, would strip Planned Parenthood's Medicaid funding for only a year, a step taken to give time for continued investigations of Planned Parenthood's activities. A House panel is still active, but investigations by 13 states have been concluded without charges of wrongdoing.

Planned Parenthood strongly denied the allegations and no wrongdoing was proved, but the group announced in October that it will no longer accept reimbursement for the costs involved in providing fetal tissue to researchers.

The defunding measure would take away roughly $400 million in Medicaid money from the group in the year after enactment, according to the nonpartisan Congressional Budget Office, and would result in roughly 400,000 women losing access to care. One factor is that being enrolled in Medicaid doesn't guarantee access to a doctor, so women denied Medicaid services from Planned Parenthood may not be able to find replacement care.

Planned Parenthood says private contributions are way up since the election, but that they are not a permanent replacement for federal reimbursements. "We're going to fight like hell to make sure our doors stay open," said Planned Parenthood spokeswoman Erica Sackin.